Hemorrhoids are a common and frequent disease. Hemorrhoid treatment methods are more, each has its indications, contraindications, if the treatment is not appropriate will occur more serious complications and sequelae. First, the classification of hemorrhoids Hemorrhoids are divided into internal hemorrhoids, external hemorrhoids and mixed hemorrhoids. Internal hemorrhoids is the anal cushion support structure, vascular plexus and arteriovenous anastomosis of pathological changes and displacement; external hemorrhoids is the dentate line distal subcutaneous vascular plexus dilatation, blood stasis, thrombosis, or tissue hyperplasia, according to the organization of the pathological characteristics of the external hemorrhoids can be divided into four categories of connective tissue, thrombosis, varicose veins and inflammatory hemorrhoids; mixed hemorrhoids is the internal hemorrhoids and the corresponding parts of the external hemorrhoids vascular plexus of the fusion of each other. Second, the diagnosis of hemorrhoids (a) clinical manifestations: 1, internal hemorrhoids: the main clinical manifestations are bleeding and prolapse, can be complicated by thrombosis, incarceration, strangulation and defecation difficulties. According to the symptoms of internal hemorrhoids, its severity is divided into 4 degrees. i degree: blood, dripping blood, bleeding can stop by itself after defecation; no hemorrhoids prolapse. ii degree: often have blood in the stool; hemorrhoids prolapse during defecation, can be self-contained after defecation. iii degree: there can be blood in the stool; defecation or standing for a long time, and coughing, straining, weight-bearing hemorrhoids, need to use the hand to return to the. iv degree: there can be blood in the stool; hemorrhoids continue to prolapse or easy to prolapse after return. 2, external hemorrhoids: the main clinical manifestations for the anal part of the soft tissue mass, anal discomfort, moist itching or foreign body sensation, such as thrombosis and inflammation can have pain. 3.Mixed hemorrhoids: the main clinical manifestations for the symptoms of internal hemorrhoids and external hemorrhoids at the same time, when the seriousness of the manifestation of ring hemorrhoidal prolapse. (B) examination methods: 1, anal diagnosis: check whether the internal hemorrhoids prolapse, the anus around the varicose external hemorrhoids, thrombosed external hemorrhoids and skin, if necessary, squatting check. Observe the site of prolapsed internal hemorrhoids, size and bleeding and hemorrhoid mucosa with or without congestion and edema, erosion and ulceration. 2, anorectal diagnosis: is an important method of examination. Internal hemorrhoids finger test is mostly no abnormality; for repeated prolapse of the III, IV degree of internal hemorrhoids, finger test can sometimes touch the fibrosis hemorrhoidal tissue on the dentate line. Anorectal diagnosis can exclude anorectal tumors and other diseases. 3, anorectal microscopy: can clarify the location of internal hemorrhoids, size, number and the surface mucosa of internal hemorrhoids with or without bleeding, edema, erosion and so on. 4.Fecal occult blood test: it is a common screening means to exclude whole digestive tract tumor. 5, the whole colonoscopy: in order to blood to the clinic, a family history of digestive tract tumors or I have a history of polyps, the age of more than 50 years old, fecal occult blood test is positive, as well as iron deficiency anemia hemorrhoids patients, it is recommended to carry out the whole colonoscopy. Third, the differential diagnosis of hemorrhoids, even with the presence of hemorrhoids, should pay attention to colorectal cancer, anal canal cancer, polyps, rectal mucosal prolapse, perianal abscess, anal fistula, anal fissure, anal papillae hypertrophy, anorectal sexually transmitted diseases and inflammatory bowel disease and other diseases for differentiation. Fourth, hemorrhoids of Chinese medicine identification 1, wind injury intestinal network evidence: stool dripping blood, ejaculation or with blood, blood color bright red, dry stool, anal itching, dry mouth and throat. Red tongue, yellow moss, floating pulse. The treatment is to cool the blood and stop bleeding. 2.Dampness and heat injection: blood in stool is bright red in color and in large amount. The anal swelling is detached, swollen, burning pain or nuisance water. Dry or loose stool, red urine. The tongue is red, the moss is yellow and greasy, and the pulse is floating. Treatment is to clear heat and dry dampness. Qi stagnation and blood stasis syndrome: the swelling is detached from the anus, edema, thrombosis, or embedded, with purple surface, erosion, oozing, severe pain, obvious tenderness, and tightness of the anal canal. Constipation in the stool and unfavorable urination. The tongue is purple or with petechiae, and the pulse is stringy or astringent. The treatment is to activate blood circulation and eliminate swelling. 4. Spleen deficiency and qi trapping syndrome: the swelling is detached from the anus, not easy to reset, the anus is swollen, defecation is weak, and the blood in the stool is pale in color. The color of the face is less gorgeous, dizziness and fatigue, less food and energy, less breath and laziness. The tongue is pale and fat, the moss is thin and white, and the pulse is weak. The treatment is to benefit the qi ascending and lifting. The treatment principle: asymptomatic hemorrhoids do not need treatment. The purpose of treatment is to eliminate and reduce the symptoms of hemorrhoids. Relieving the symptoms of hemorrhoids is more meaningful than changing the size of hemorrhoids, and should be regarded as the standard of treatment effect. (A) general treatment: improve diet, keep bowel movement, pay attention to perianal cleansing and sitz baths are effective in the treatment of all types of hemorrhoids. (B) drug treatment: drug treatment is an important method of hemorrhoid treatment, I, II degree internal hemorrhoid patients should be preferred drug treatment. 1, local drug treatment: including suppositories, creams, lotions. Containing carrageenan acid mucosal repair protection and lubrication components of the suppository, cream on hemorrhoids have a better therapeutic effect. Drugs containing steroid derivatives can relieve symptoms in the acute stage, but should not be used long-term and preventive. 2.Systemic drug therapy: commonly used drugs include intravenous enhancers, anti-inflammatory and analgesic drugs. (1) Intravenous enhancers: commonly used are micronized purified flavonoid components, herbaceous rhinoceros infusion tablets, ginkgo biloba extract, etc., which can alleviate the symptoms of internal hemorrhoids in the acute stage, but the combined use of several kinds of venous enhancers has no obvious superiority; (2) anti-inflammatory and analgesic drugs: it can effectively alleviate the pain caused by internal hemorrhoids or thrombosed external hemorrhoids; (3) dialectical treatment of traditional Chinese medicine. (3) Sclerotherapy: submucosal sclerotherapy is an effective method of treating internal hemorrhoids, which is mainly applicable to internal hemorrhoids of I and II degrees, with remarkable recent efficacy. Complications include local pain, burning sensation in the anus, necrotic ulcers or anal stenosis, hemorrhoidal thrombosis, submucosal abscesses and hard nodules. External hemorrhoids and hemorrhoids during pregnancy should be contraindicated. (D) Instrumental treatment: 1, adhesive ring ligation therapy: applicable to all degrees of internal hemorrhoids and mixed hemorrhoids internal hemorrhoids part, especially II, III degrees of internal hemorrhoids with bleeding and / or prolapse. The ligation site is in the region of the dentate line. Complications include rectal discomfort and distension, pain, slippage of the rubber ring, delayed bleeding, edema of the anal skin, thrombosed external hemorrhoids, ulcer formation, pelvic infection, and so on. 2.Chinese medicine thread ligation: use silk thread or medicine silk thread, paper wrapped medicine thread wrapped in the root of the hemorrhoid nucleus, so that the hemorrhoid nucleus necrosis and fall off, the wound is repaired and healed. 3, physical therapy: including laser therapy, cryotherapy, direct current therapy and copper ion electrochemistry, microwave thermocoagulation therapy, infrared coagulation therapy. The main indications are I, II, III degree internal hemorrhoids. The main complications are bleeding, edema, delayed wound healing and infection. (E) Surgical treatment: Indications: internal hemorrhoids have developed to III, IV degree, or II degree internal hemorrhoids with severe bleeding; acute embedded hemorrhoids, necrotic hemorrhoids, mixed hemorrhoids and external hemorrhoids with significant symptoms and signs; non-surgical treatment is ineffective and there are no contraindications for surgery.